MUR changes – 10 things you need to know

Changes to the requirements for recording MURs in England will be introduced from July 1 2012, here are the 10 things you need to know.

1. What changes are being introduced on July 1?

Changes to the MUR service in England will be implemented from July 1 2012, building on the amendments introduced in October 2011. They include:
 
*  Changes to the data pharmacy contractors need to collect during an MUR consultation
*  Changes to when and how a pharmacist needs to inform a GP a patient on their list has had an MUR
*  Additional information pharmacy contractors should report to the PCT on request.
 

2. Are similar changes happening in Wales?

 
No. These changes only apply to MURs in England; there will be no changes to data collection and reporting processes in Wales.
 

3. Do I still need to use the current MUR form?

 
No. From July 1 pharmacists are no longer required to use the current MUR form, or MUR consultation record. This has been replaced by a requirement to capture an MUR dataset for each consultation.
 

4. What data do I need to collect during each MUR?

 
According to PSNC, the following data should be recorded:
 
a. Patient demographic details
a)   Name
b)   Address
c)   Gender
d)   Date of birth
e)   NHS number (where available)
f)    Ethnicity
 
b.    Registered GP practice
 
c. Target group
a)   Respiratory
b)   High risk medicine
c)   Post-discharge
d)   Not in a target group
 
d. Total number of medicines being used by the patient
a)   Prescribed
b)   Over the counter and complementary therapies
 
e. Healthy living advice provided during the MUR (using the following options):
a)   Diet and nutrition
b)   Smoking
c)   Physical activity
d)   Alcohol
e)   Sexual health
f)    Weight management
g)   Other
h)   Healthy living advice not applicable at this consultation
 
f. Matters identified during the MUR (using the following options)
a)   Patient not using a medicine as prescribed (non-adherence)
b)   Problem with pharmaceutical form of a medicine or use of a device
c)   Patient reports need for more information about a medicine or condition
d)   Patient reports side effects or other concern about a medicine
e)   Other
 
g. No matters identified during the MUR
 
h. Action taken / to be taken
a)   Information / advice provided
b)   Yellow card report submitted to the MHRA
c)   Referral – patient's issues raised with the medicine need to be considered by the GP practice or another primary health care provider
d)   Other
 
i. As a result of the MUR the pharmacist believes there will be an improvement in the patient's adherence to their medicines as a result of the following:
a)   Better understanding / reinforcement of why they are using the medicine / what it is for
b)   Better understanding / reinforcement of when / how to take the medicines
c)    Better understanding / reinforcement of side effects and how to manage them
d)   Better understanding / reinforcement of the condition being treated.
 
You can keep additional clinical records to support the patient's care if you feel it is appropriate.
 

5. How do I collect the data?

 
You must keep the data for two years from the date the service is completed. The data can be stored electronically.
 
PSNC have developed a variety of worksheets for collecting the required data.
 
In Wales, pharmacists should continue to use the standard MUR form.
 

6. Do I need to continue to inform a patient's GP that an MUR has taken place?

 
Not necessarily. From July 1 you are only required to contact a patient's GP if an issue is identified during the MUR where you believe the GP should be informed; you are no longer required to routinely inform a patient's GP that an MUR has been conducted.
 

7. How should I provide feedback to a patient's GP?

 
You should complete an MUR feedback form, which has been developed by the Professional Relationships Working Group (PRWG), and send this to the patient's GP.
 
Although this is the approved feedback form, you can still contact the patient's GP if an urgent issue has been identified during the MUR; however you should then follow up in writing using the PRWG form.
 
 

8. Do I still need to provide MUR information to my PCT if they request it?

 
Yes; this requirement was added in October 2011, and additional information has been added to the list pharmacists are required to submit from July 1 2012 onwards.
 

9. What information do I need to send to my PCT if requested?

 
According to PSNC, the information you are requested to submit is as follows (the new requirements are in bold):
 
1. Total number of MURs delivered to patients in each group:
1.1  Respiratory
1.2  High risk medicine
1.3  Post-discharge
1.4  Non target group
 
2. Total number of medicines being used by patients who received an MUR during the quarter sub-divided between:
2.1  Prescribed
2.2  Over the counter and complementary therapies
 
3. Number of patients where a medication issue was identified by the pharmacist and action was taken
 
4. Number of patients referred back to the GP practice or another primary health care provider
 
5. Number of patients where as a result of the MUR the pharmacist believes there will be an improvement in the patient's adherence to the medicines and type of benefit (more than one may apply):
5.1  Better understanding of why they are using the medicine/what it is for
5.2  Better understanding of when/how to take the medicines
5.3  Better understanding of side effects and how to manage them
5.4  Better understanding of the condition being treated
 
6. Total number of patients given brief advice about a healthier lifestyle and type of advice:
6.1  Diet and nutrition
6.2  Smoking
6.3  Physical activity
6.4  Alcohol
6.5  Sexual health
6.6  Weight management
6.7  Other
 

10. How do I send this information?

 
You need to collate the records of your MURs conducted in each quarter within 10 working days from the last day of June, September, December and March each year. You should then submit them to the PCT or successor organisation on request. Again, PSNC has a range of worksheets to help pharmacists record the correct information.